REPUBLIKA NG PILIPINAS

PASEGURUHAN NG MGA NAGLILINGKOD SA PAMAHALAAN

(GOVERNMENT SERVICE INSURANCE SYSTEM)
Financial Center, Roxas Boulevard, Pasay City 1308

NON-DISCLOSURE UNDERTAKING

I, ______________________________, single/married/widow/widower, of legal age, Filipino,

with residence and postal address at ____________________________________, engaged under
Job Order (JO) No. ____________ assigned at the ______________________________, Government
Service Insurance System (GSIS) effective _________________.

In the course of my engagement as JO, I may acquire knowledge of and gain access to
information concerning the affairs of the GSIS which are not available to the public, including the
personal information of GSIS members, employees and third parties, and certain ideas, information,
reports and other documents related to GSIS operations, which are confidential and proprietary to the
GSIS (hereinafter collectively referred to as “Confidential Information”).

I, therefore, state under oath that:

1. I shall only use Confidential Information within the limits of and in the performance of
my assigned duties and responsibilities;

2. I shall have the perpetual duty to protect all Confidential Information which I may
acquire knowledge of or gain access to in the course of my engagement with the GSIS.
Pursuant thereto, I shall, among others, undertake to:

a. Keep private and not publish, use or disclose to any other individual or entity, either
directly or indirectly, any Confidential Information and prevent such information
from falling into the public domain or into the possession of unauthorized persons or
third party;

b. Not reverse, decompile, disassemble or decode any software or portion thereof or

derive any source code, reproduce or copy any of the Confidential Information; and

c. Not copy, distribute or reproduce in any form, any and all information, data,
statistics, reports, communications or any document which I may receive or have
access to during my engagement;

3. I shall immediately turn-over and return all official records and documents in my custody
or possession upon the expiration or termination (voluntarily or involuntarily) of my
Contract;

4. I fully understand my accountabilities and undertake to perform my responsibilities as

stated in this Undertaking. I fully understand that my responsibilities and accountabilities
for information confidentiality extends beyond the term of my Contract with GSIS; and

5. I understand that I maybe held criminally or civilly liable for any violation of this
Undertaking.

____________________________
Name and Signature of JO

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 SUBSCRIBED AND SWORN TO BEFORE ME this _________ day of
____________________, affiant exhibiting to me his/her (any valid ID) issued at
____________________ on ____________________.

Notary Public

Doc. No. _____

Page No._____
Book No._____
Series of _____

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